Journal of Immigrant and Minority Health

, Volume 16, Issue 1, pp 111–118 | Cite as

Ethnicity and Self-Perceived Oral Health in Colombia: A Cross-Sectional Analysis

  • Andrés A. Agudelo-Suárez
  • Eliana Martínez-Herrera
  • Adriana Posada-López
  • Danilo Sánchez-Patiño
  • Yomaira Viñas-Sarmiento
Original Paper


To estimate the association between self-perceived oral health indicators and ethnic origin in Colombia, a cross-sectional study (Information from the 2007 National Public Health Survey) was conducted. Variables: belonging to an ethnic group (Exposure); oral health indicators (Outcomes); sex, age, education and self-rated health (control). Analyses were carried out separately for men (M) and women (W). The association between the exposure variable and the outcomes was estimated by means of adjusted odds ratio (OR) with confidence intervals (95 % CI) using logistic regression. Men were more likely to report gum bleeding (aOR 1.78; 95 % CI 1.44–2.23) and dental caries (aOR 1.69; 95 % CI 1.42–2.02), while women were more likely to report unmet dental needs (aOR 1.43; 95 % CI 1.27–1.49) and dental caries (aOR 1.34; 95 % CI 1.22–1.47). Indigenous and Palenquero were more likely to report most of the indicators analyzed. Minority ethnic groups in Colombia were at risk to report oral health problems.


Ethnicity Oral health Health surveys Inequalities Colombia 


  1. 1.
    Selwitz RH, Ismail AI, Pitts NB. Dental caries. The Lancet. 2007;369(9555):51–9.CrossRefGoogle Scholar
  2. 2.
    Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am. 2005;49(3):517.PubMedCrossRefGoogle Scholar
  3. 3.
    Watt RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol. 2007;35(1):1–11.PubMedCrossRefGoogle Scholar
  4. 4.
    Watt RG. Emerging theories into the social determinants of health: implications for oral health promotion. Community Dent Oral Epidemiol. 2002;30(4):241–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Petersen PE, Kwan S. Equity, social determinants and public health programmes–the case of oral health. Community Dent Oral Epidemiol. 2011;39(6):481–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Benzian H, Hobdell M, Holmgren C, Yee R, Monse B, Barnard JT, et al. Political priority of global oral health: an analysis of reasons for international neglect. Int Dent J. 2011;61(3):124–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Colombia. Departamento Administrativo Nacional de Estadística (DANE) [Administrative Nacional Department of Statistics]. Colombia. Una nación multicultural. Su diversidad étnica. [Colombia. A multicultural nation. Its ethnic diversity]. Bogotá: Departamento Administrativo Nacional de Estadística; 2005.Google Scholar
  8. 8.
    Wade P. [Ethnicity, multiculturalism and social policy in Latin America: Afro-Latin (and indigenous) populations]. Traducción del manuscrito en inglés de María Luisa Valencia. Tabula Rasa. Bogotá–Colombia. 2006; 4: 59–81.Google Scholar
  9. 9.
    Torres C. La equidad en materia de salud vista con enfoque étnico. [Equity in health as seen from an ethnic focus]. Rev Panam Salud Publica. 2001;10(3):188–201.PubMedCrossRefGoogle Scholar
  10. 10.
    World Health Organization (WHO). A conceptual framework for action on the social determinants of health: social determinants of health discussion Paper 2. Geneva: World Health Organization (WHO); 2010.Google Scholar
  11. 11.
    Cruz GD, Galvis DL, Kim M, Le-Geros RZ, Barrow SYL, Tavares M, et al. Self-perceived oral health among three subgroups of Asian Americans in New York City: a preliminary study. Community Dent Oral Epidemiol. 2001;29(2):99–106.PubMedCrossRefGoogle Scholar
  12. 12.
    Sundby A, Petersen PE. Oral health status in relation to ethnicity of children in the Municipality of Copenhagen, Denmark. Int J Paediatr Dent. 2003;13(3):150–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Cruz GD, Chen Y, Salazar CR, Le Geros RZ. The association of immigration and acculturation attributes with oral health among immigrants in New York City. Am J Public Health. 2009;99(Suppl 2):S474–80.PubMedCrossRefGoogle Scholar
  14. 14.
    Barriuso Lapresa L, Sanz Barbero B. Análisis multinivel del uso de servicios de salud bucodental por población infanto-juvenil. [Multilevel analysis of the use of oral health services by the pediatric population]. Gac Sanit. 2011;25(5):391–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Barriuso Lapresa L, Sanz Barbero B. Variables asociadas al uso de los servicios de salud bucodental por la población preescolar en España: un análisis de la Encuesta Nacional de Salud. [Variables associated with the use of dental services among preschool population in Spain: A National Health Survey Analysis]. Rev Esp Salud Pública. 2012;86(1):115–24.PubMedCrossRefGoogle Scholar
  16. 16.
    León LM, Olmos JM. Prevalencia de caries y factores asociados en niños de 2–5 años de los Centros de Salud Almanjáyar y Cartuja de Granada capital [The prevalence of caries and associated factors in children 2–5 years old from the Almanjáyar and Cartuja Health Centers of the capital Granada]. Aten Primaria. 2000;26:398–404.CrossRefGoogle Scholar
  17. 17.
    Guarnizo-Herreño CC, Wehby GL. Explaining racial/ethnic disparities in children’s dental health: a decomposition analysis. Am J Public Health. 2012;102(5):859–66.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Lau M, Lin H, Flores G. Racial/ethnic disparities in health and health care among US adolescents. Health Serv Res. 2012;47(5):2031–59.PubMedCrossRefGoogle Scholar
  19. 19.
    Bernal R, Cardenas M. Race and ethnic inequality in health and health care in Colombia. Working papers series N° 25. Bogota: Fedesarrollo; 2005.Google Scholar
  20. 20.
    Colombia. Ministerio de la Protección Social. [Ministry of Social Protection]. Encuesta Nacional de Salud Pública. [National Public Health Survey]. Bogotá: Ministerio de la Protección Social 2007.Google Scholar
  21. 21.
    Kunkel SR, Atchley RC. Why gender matters: being female is not the same as not being male. Am J Prev Med. 1996;51:294–6.Google Scholar
  22. 22.
    Schiaffino A, Rodríguez M, Pasarín MI, Regidor E, Borrell C, Fernández E. ¿Odds ratio o razón de proporciones?: su utilización en estudios transversales. [Odds ratio or prevalence ratio? Their use in cross-sectional studies]. Gac Sanit. 2003;17(1):70–4.PubMedGoogle Scholar
  23. 23.
    Marmot M, Wilkinson R, editors. Social determinants of health. Oxford: Oxford University Press; 2006.Google Scholar
  24. 24.
    Gil-González D, Ruiz-Cantero MT, Alvarez-Dardet C. How political epidemiology research can address why the millennium development goals have not been achieved: developing a research agenda. J Epidemiol Community Health. 2009;63(4):278–80.PubMedCrossRefGoogle Scholar
  25. 25.
    Bambra C, Fox D, Scott-Samuel A. Towards a politics of health. Health Promot Int. 2005;20(2):187–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Internal Displacement Monitoring Centre. Internal Displacement Profile (Colombia). Accessed 10 Jun 2012.
  27. 27.
    Pan-American Health Organization. Population Displacement. Accessed 10 Jun 2012.
  28. 28.
    Watt R. Emerging theories into the social determinants of health: implications for oral health promotion. Community Dent Oral Epidemiol. 2002;30:241–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Gao XL, McGrath C. A review on the oral health impacts of acculturation. J Immigr Minor Health. 2011;13(2):202–13.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Garcia RI, Cadoret CA, Henshaw M. Multicultural issues in oral health. Dent Clin North Am. 2008;52(2):319–32.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Courtenay WH. Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med. 2000;50(10):1385–401.PubMedCrossRefGoogle Scholar
  32. 32.
    Matud Aznar MP, Bethencourt Pérez JM, Ibáñez Fernández I, López Curbelo M. Roles de género y salud de mujeres y hombres. [Gender roles and health of women and men]. Análisis y Modificación de Conducta. 2010;36(153):37–48.Google Scholar
  33. 33.
    Kreimer M. Labour market segregation and the gender-based division of labour. Eur J Womens Stud. 2004;11:223–46.CrossRefGoogle Scholar
  34. 34.
    Chodorow NJ. Glass ceilings, sticky floors, and concrete walls: internal and external barriers to women’s work and achievement. In: Seelig BJ, Paul RA, Levy CB, editors. Constructing and deconstructing woman’s power. 1st ed. London: Communication Crafts; 2002. p. 18–28.Google Scholar
  35. 35.
    Salazar E. Mujer y salud: Significado y responsabilidad. [Women and Health: Meaning and responsibility]. Investigación en enfermería: Imagen y Desarrollo. 2003;5(1–2):41–51.Google Scholar
  36. 36.
    Alemán Sánchez PC, González Valdés D, Delgado Díaz Y, Acosta Acosta E. La familia y su papel en los problemas de promoción y prevención de salud bucal. [The family and its role in the problems of promotion and prevention of oral health]. Rev Cubana Estomatol. 2007; 44(1): Accessed 09 Apr 2013.
  37. 37.
    Fukai K, Takaesu Y, Maki Y. Gender differences in oral health behavior and general health habits in an adult population. Bull Tokyo Dent Coll. 1999;40(4):187–93.PubMedCrossRefGoogle Scholar
  38. 38.
    Bawadi HA, Khader YS, Haroun TF, Al-Omari M, Tayyem RF. The association between periodontal disease, physical activity and healthy diet among adults in Jordan. J Periodontal Res. 2011;46(1):74–81.PubMedCrossRefGoogle Scholar
  39. 39.
    Agudelo-Suárez AA, Martínez-Herrera E. Collective oral health and the Colombian context: a critical analysis. [La salud bucal colectiva y el contexto colombiano: un análisis crítico]. Rev Gerenc Polit Salud, Bogotá (Colombia). 2009;8(16):91–105.Google Scholar
  40. 40.
    Guerrero R, Gallego AI, Becerril-Montekio V, Vásquez J. Sistema de salud de Colombia. [The health system of Colombia]. Salud Publica Mex. 2011;53(Suppl 2):s144–55.PubMedGoogle Scholar
  41. 41.
    Rodríguez Acosta S. Barreras y determinantes del acceso a los servicios de salud en Colombia. Barcelona: Universitat Autònoma de Barcelona; 2010.Google Scholar
  42. 42.
    Ariza-Montoya, JF Hernández-Álvarez, M E. Equidad de Etnia en el Acceso a los Servicios de Salud en Bogotá, Colombia, 2007. Rev. salud pública. 2008; 10 (suppl.1): 58-71.Google Scholar
  43. 43.
    Scheppers E, van Dongen E, Dekker J, Geertzen J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006;23(3):325–48.PubMedCrossRefGoogle Scholar
  44. 44.
    Fassaert T, Hesselink AE, Verhoeff AP. Acculturation and use of health care services by Turkish and Moroccan migrants: a cross-sectional population-based study. BMC Public Health. 2009;9:332.PubMedCentralPubMedCrossRefGoogle Scholar
  45. 45.
    Lauderdale DS, Wen M, Jacobs EA, Kandula NR. Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003. Med Care. 2006;44(10):914–20.PubMedCrossRefGoogle Scholar
  46. 46.
    Agudelo Calderón CA, Cardona Botero J, Ortega Bolaños J, Robledo Martínez R. Sistema de salud en Colombia: 20 años de logros y problemas [The Colombian healthcare system: 20 years of achievements and problems]. Ciênc saúde coletiva. 2011;16(6):2817–28.CrossRefGoogle Scholar
  47. 47.
    World Health Organization, Commission on Social Determinants of Health. Social determinants and Indigenous health: The International experience and its policy implications. Geneva: WHO; 2007.Google Scholar
  48. 48.
    Hart JT. The inverse care law. Lancet. 1971;1(7696):405–12.PubMedCrossRefGoogle Scholar
  49. 49.
    Frohlich KL, Potvin L. Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations. Am J Public Health. 2008;98(2):216–21.PubMedCrossRefGoogle Scholar
  50. 50.
    US Department of Health and Human Services. The Office of Minority Health. Racial and Ethnic Specific Oral Health Data 2012. Accessed 10 may 2012.
  51. 51.
    Cruz GD, Galvis DL, Kim M, Le-Geros RZ, Barrow SYL, Tavares M, et al. Self-perceived oral health among three subgroups of Asian-Americans in New York City: a preliminary study. Community Dent Oral Epidemiol. 2001;29(2):99–106.PubMedCrossRefGoogle Scholar
  52. 52.
    Sabbah W, Tsakos G, Sheiham A, Watt RG. The effects of income and education on ethnic differences in oral health: a study in US adults. J Epidemiol Community Health. 2009;63(7):516–20.PubMedCrossRefGoogle Scholar
  53. 53.
    Segovia J, Bartlett RF, Edwards AC. An empirical analysis of the dimensions of health status measures. Soc Sci Med. 1989;29(6):761–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Andrés A. Agudelo-Suárez
    • 1
  • Eliana Martínez-Herrera
    • 2
  • Adriana Posada-López
    • 1
  • Danilo Sánchez-Patiño
    • 1
  • Yomaira Viñas-Sarmiento
    • 1
  1. 1.Department of Basic Studies, Faculty of DentistryUniversity of AntioquiaMedellinColombia
  2. 2.National School of Public HealthUniversity of AntioquiaMedellínColombia

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